Ex-aide now runs Keswick Changeover: There is a new man at the helm of the board of Keswick Multi-Care Center, where all things are undertaken with deliberation.

August 17, 1998|By M. William Salganik | M. William Salganik,SUN STAFF

Keswick Multi-Care Center doesn't alter itself lightly. Even when there's a changing of the guard, more than a whiff of Old Guard remains.

"I came on the board 10 years ago, and that qualifies me as a newcomer," says Edmond P. Nolley Jr., who recently become president of the nonprofit's board. By Nolley's count, he's only the eighth board president since Keswick began in 1883 as the Home for Incurables of Baltimore City.

He replaces Henry S. Baker Jr., president for 20 years and a board member for 40 -- long enough for the departing president to remember a time when the home itself was run by the Board of Lady Managers while a parallel board of businessmen was "concerned with the finances." (Baker remains a member of the board.)

And before Nolley joined the board, he was a volunteer, and even before that he was a $1.10-an-hour aide at Keswick, for the summers of 1965, 1966 and 1967, while he was a student at Baltimore City College and Loyola College, performing such chores as bathing patients.

Despite its rootedness in the past, Keswick has made some adaptations, however. In recent years, it has gone beyond its long-standing nursing home status to add adult day care, assisted living and a "transitional" unit for people leaving the hospital but not quite ready to go home.

The name changes over the years, from Home for Incurables to Keswick Nursing Home to Keswick Multi-Care Center, "talks to our broadened mission," Baker said.

Now, Keswick is looking at other services it might offer the elderly, on or off its North Baltimore campus that faces the Rotunda shopping center. Possibilities being considered, Nolley said, include going into nearby apartment high-rises with clinical services, bringing elderly residents to Keswick by van for care, -- and offering such personal services as "cutting the grass and balancing the checkbook."

Baker added, "There's a tremendous elderly population in this area, and we're looking at what we could be doing to benefit these people."

It's part of a strategic planning process lasting through the end of the year; a committee is considering expanded assisted living (now 46 units) and other options largely directed at exposing more people to Keswick to assure a continuing supply of potential residents for its 199 nursing home beds.

"We're not looking to go out and create a revenue producer," Nolley said. "We're trying to raise the visibility of Keswick in the market. The people that know it are the families that have been coming here for generations."

That's certainly not to say Keswick is facing terrible problems. Its endowment, fed by bequests over the years, is more than $50 million, generating income that goes to subsidize care. Volunteers contribute about 30,000 hours a year.

Occupancy in the nursing home is about 90 percent. More than half the residents are private-pay, at rates some 40 percent higher than those paid by Medicare and Medicaid.

Keswick operates in the black, although, Nolley said, it spends $2 million to $3 million a year in endowment income to subsidize care and provide extra-quality touches. Operating income is about $15 million to $16 million a year. It maintains a staff size roughly equal to the number of residents. However, Nolley said, changes in the health market could mean problems for Keswick down the road. Hospital systems, which used to refer patients to Keswick's nursing care, and for-profit chains are offering variety of options for long-term care and housing for the elderly.

"Competition is everywhere now," Nolley said. "It used to be we had the whole North Baltimore niche to ourselves."

The strategic planning process has led to a decision to streamline the board from about three dozen people, heavy on business and financial backgrounds, to about 15, with more background in long-term care.

And, Nolley said, the board feels compelled, in an era of rapid consolidation in health care, to consider options for Keswick.

"We'd like to remain independent," he said. "But we want to make sure we are performing responsibly as a board by looking at all the alternatives. We are not immune to the turmoil that's out there."

"It's foolish to think we can go it alone forever," Baker said.

But both the old president and the new one say there is no need for Keswick to rush into a merger, and they say if Keswick were to join a larger organization, it would almost certainly be a nonprofit one.

While, as befits Keswick's habits, change may not come rapidly, it should become visible next year, as the strategic planning process is completed and the institution begins to implement recommendations.

"I'm really excited about Keswick's future, with our strong reputation and strong backing," Nolley said; "1999 will be a pivotal year, and a good year, for us -- the year we start to pull things together."

Pub Date: 8/17/98

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